Search

Access cavity preparation represents the initial step in root canal treatment. Minimally invasive approaches have gained increasing attention and involve advancements in the traditional access cavity preparation. Simultaneously, the development of three‐dimensional finite element analysis (3D‐FEA) has provided a theoretical foundation for evaluating the merits and drawbacks of various access cavity preparations. Studies using static loading 3D‐FEA have suggested that conservative access cavity preparation reduces the concentration of stress in the cervical region, thereby strengthening fracture resistance. However, the lack of support from clinical data raises concerns about the validity of this suggestion. Conversely, studies involving cyclic loading 3D‐FEA and dynamic loading 3D‐FEA have challenged the prevailing perspectives by taking into account additional factors such as filling materials, thus providing a more comprehensive understanding of the impact of access cavity preparation on fracture resistance. Existing research lacks a comprehensive comparison of the different 3D‐FEA methods, and this review fills this gap by providing a systematic assessment of different 3D‐FEA methods and their applications in access cavity preparation. [ABSTRACT FROM AUTHOR]

Purpose: To assess vertical and horizontal fit, screw removal torque, and stress analysis (considered biomechanical aspects) of full‐arch implant frameworks manufactured in Ti‐6Al‐4V through milling, and additive manufacturing Direct Metal Laser Sintering (DMLS) and Electron Beam Melting (EBM), and the effect of the thermo‐mechanical treatment Hot Isostatic Pressing (HIP) as a post‐treatment after manufacturing. Material and Methods: Maxillary full‐arch implant frameworks were made by milling, DMLS, and EBM. The biomechanical assessments were screw removal torque, strain‐gauge analyses, and vertical and horizontal marginal fits. The vertical fit was assessed by the single‐screw test and with all screws tightened. All frameworks were submitted to a standardized HIP cycle (920°C, 1000 bar pressure, 2 h), and the tests were repeated (α = 0.05). Results: At the initial time, milled frameworks presented higher screw removal torque values, and DMLS and EBM frameworks presented lower levels of strain. Using the single‐screw test, milled and DMLS frameworks presented higher vertical fit values, and with all screws tightened and horizontally, higher fit values were found for milled frameworks, followed by DMLS and EBM. After HIP, milling and EBM frameworks presented higher screw removal torque values; the lowest strain values were found for EBM. Using the single‐screw test, milled and DMLS frameworks presented higher vertical fit values, and with all screws tightened and horizontally no differences were found. Conclusions: DMLS and EBM full‐arch frameworks presented adequate values of screw removal torque, strain, and marginal fit, although the worst values of marginal fit were found for EBM frameworks. The HIP cycle enhanced the screw removal torque of milled and EBM frameworks and reduced the strain values of milled frameworks. The HIP represents a reliable post‐treatment for Ti‐6Al‐4V dental prostheses produced by milling and EBM technologies. [ABSTRACT FROM AUTHOR]

Copyright of Aydin Dental Journal is the property of Aydin Dental Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this review was to provide an update on the current status of digital occlusal force measurement devices, as well as clinical and research applications in complete arch maximum occlusal force measurement. SCOPUS, ScienceDirect, and PubMed databases were used to conduct a literature search from January 2001 to January 2021. Identification and screening of literature were done independently according to published guidelines and selection criteria. The electronic searches turned up 394 articles, 16 of which met the inclusion and exclusion criteria and were selected for study analysis. All of these studies used T-scan and Dental Prescale digital occlusal analysis system with pressure-sensitive foils as occlusal force measurement devices. The devices showed a promising potential for identifying and comprehending maximum occlusal forces objectively. According to the current review, maximum occlusal force measured with digital occlusal force devices can be used as a prosthodontic adjunct to address issues that arise during the treatment of occlusal disorders, temporomandibular disorders, and complete dentures. It is also useful in predicting cognitive and functional decline in the elderly. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Prevention & Treatment For Stomatological Diseases is the property of Journal of Prevention & Treatment For Stomatological Diseases Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract To evaluate the polymerization shrinkage stress and cuspal strain (CS) generated in an artificial (typodont) and in a natural tooth using different resin composites. Twenty artificial and 20 extracted natural molars were selected. Each tooth was prepared with a 4x4 mm MOD cavity. The natural and typodont teeth were divided into four experimental groups (n=10), according to the resin composite used: Filtek Z100 (3M Oral Care) and Beautifil II LS (Shofu Dental). The cavities were filled using two horizontal increments and the CS (µS) was measured by the strain gauge method. Samples were sectioned into stick-shaped specimens and the bond strength (BS) (MPa) was evaluated using a microtensile BS test. Shrinkage stress and CS were analyzed using 3D finite element analysis. No difference was found between the type of teeth for the CS as shown by the pooled averages: Natural tooth: 541.2 A; Typodont model: 591.4 A. Filtek Z100 CS values were higher than those obtained for Beautifil II LS, regardless of the type of teeth. No statistical difference was found for the BS data. Adhesive failures were more prevalent (79.9%). High shrinkage stress values were observed for Filtek Z100 resin, regardless of tooth type. The CS of typodont teeth showed a shrinkage stress effect, generated during restoration, equivalent to that of natural teeth.

Background. A key factor for the success or failure of an implant is how the stresses are transferred to the surrounding bone. The implant‒abutment connection (IAC) is paramount for implant success. The purpose of this finite element analysis (FEA) study was to evaluate the stress distribution in and around three different implant‒abutment interfaces with platform-switched and platform-matched abutments using the finite element method (FEM). Methods. Three distinct types of IAC were selected: tri-channel internal connection, conical connection, and internal hex connection. Six models were generated, three in platform-switched and three in non-platform-switched configuration. Computer-Aided Three-Dimensional Interactive Application (CATIA) V5 R20 software was used to generate virtual models of the implants and the mandible. The models were transferred to Analysis of Systems (ANSYS) 15.0 software, in which the models were meshed and underwent FEA. Results. On the crestal bone, the highest von Mises stresses in platform-switched abutments were noticed in the internal hex implant‒abutment system (370 MPa), followed by the tri-channel implant‒abutment system (190 MPa) and conical implant‒abutment system (110 MPa). On the implant and the abutment screw, the highest von Mises stresses were observed in the internal hex implant‒abutment system, followed by the conical implant abutment system and tri-channel implant‒abutment system. Platform-switched implants had a more favorable stress distribution on crestal bone. Conclusion. Within the constraints of the current study, the internal hex connection exhibited the highest stress. In contrast, the conical abutment connection with platform switching configuration had more favorable stress distribution in crestal bone than other implant abutment systems.

The restoration of endodontically treated teeth is one of the main challenges of restorative dentistry. The structure of the tooth is a complex assembly in which the materials that make it up, enamel and dentin, have very different mechanical behaviors. Therefore, finding alternative replacement materials for dental crowns in the area of restorative care isa highly significant challenge, since materials such as ceramic and zirconia have very different stress load resistance values. The aim of this study is to assess which material, either ceramic or zirconia, optimizes the behavior of a restored tooth under various typical clinical conditions and the masticatory load. A finite element analysis (FEA) framework is developed for this purpose. The 3D model of the restored tooth is input into the FEA software (Ansys Workbench R23)and meshed into tetrahedral elements. The presence of masticatory forces is considered: in particular, vertical, 45° inclined, and horizontal resultant forces of 280 N are applied on five contact points of the occlusal surface. The numerical results show that the maximum stress developed in the restored tooth including a ceramic crown and subject to axial load is about 39.381 MPa, which is rather close to the 62.32 MPa stress computed for the natural tooth; stresses of about 18 MPa are localized at the roots of both crown materials. In the case of the zirconia crown, the stresses are much higher than those in the ceramic crown, except for the 45° load direction, while, for the horizontal loads, the stress peak in the zirconia crown is almost three times as large as its counterpart in the ceramic crown (i.e., 163.24 MPa vs. 56.114 MPa, respectively). Therefore, the zirconia crown exhibits higher stresses than enamel and ceramic that could increase in the case of parafunctions, such as bruxism. The clinician's choice between the two materials should be evaluated based on the patient's medical condition. [ABSTRACT FROM AUTHOR]

Bone density at the implant site is correlated to the success of osseointegration. The objective of this in vitro study was to evaluate the efficacy of osseodensification burs in increasing bone density using a solid polyurethane foam block model. The osseodensification burs kit was used to perform 48 osteotomies on a rigid polyurethane foam test ground. Burs were utilized on a TMM2 implant motor for data collection. The osteotomies were divided into two study groups (A and C) in which implant sites, extended 12 and 14 mm deep, respectively, were prepared using the drills to a compaction rotation; two control groups, B and D, represented the osteotomies for which the drills were used in cutting direction. A 3.8 × 12 mm conical implant was inserted into each site; for each implant, data were collected on the peak torque (Cp), mean torque (Cm), and integral depth curve (I). The implants underwent resonance frequency analysis (RFA) to assess the implant stability quotient (ISQ). Correlation analysis was performed between I, Cm, Cp and ISQ. One-way analysis of variance (ANOVA) was used to identify statistically significant differences between groups. Group C, representing osteotomies prepared at 14 mm with osseodensification burs, showed a significantly higher value for each parameter. Implants at sites obtained with osteocondensation drills and prepared at greater depth for autologous particle grafting showed significant increases in each implant stability parameter. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effect of glass–ceramic coated zirconia versus alumina air-abraded zirconia on the shear bond strength (SBS) of resin cement and investigate the residual stresses present on both mechanically pre-treated surfaces. Materials and Methods: A total of 180 zirconia disks, with diameters of 10 mm and 5 mm, were divided into two groups: DCMhotbond glass–ceramic coated, followed by hydrofluoric acid etching (DCM), and alumina air-abraded (AB). All mechanically pre-treated disks were conditioned with G-Multi Primer and bonded using G-Cem Linkforce Cement. Ninety specimens were immersed in distilled water for 24 h and subsequently allocated into three groups based on aging conditions (n = 15/subgroups): immediate testing, 5000 thermal cycles, and 10,000 thermal cycles. Then, the shear bond strength was assessed, and the obtained data were subjected to analysis using a two-way ANOVA, followed by a one-way ANOVA and Tukey's HSD post hoc test (α = 0.05). The residual stresses present on both mechanically pre-treated surfaces were examined using X-ray diffraction analysis. Results: The mean SBS values of the DCM and AB groups showed no significant difference under each aging condition. The SBS of DCM groups was not affected by thermal cycles, whereas the SBS of AB groups exhibited a significant decrease following thermal cycles. Glass–ceramic coated surfaces exhibited higher compressive stresses than alumina air-abrasion. Conclusions: The DCMhotbond glass–ceramic coated zirconia showed comparable bond strength to the alumina air-abrasion technique. Clinical Relevance: The DCMhotbond glass–ceramic coating technique is a promising alternative for zirconia surface pre-treatment. However, further investigations are needed before suggesting its clinical use. [ABSTRACT FROM AUTHOR]

The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1–LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (Pmax) and minimum principal stress (Pmin) and equivalent stress (Peqv) values. The highest peak Pmax values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 Pmax: 89.57 MPa, S2 Pmax: 102.98 MPa) and trabecular bone (S1 Pmax: 3.03 MPa, S2 Pmax: 2.62 MPa). Overall, LC1—where masticatory forces covered the entire mesio−distal surface of the denture, including the cantilever—was the most advantageous. Peak Pmax values in the cortical bone and the trabecular bone were 14.97–15.87% and 87.96–94.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance. [ABSTRACT FROM AUTHOR]

Purpose: To examine the strains in the collar area of implants supporting a cantilevered cross‐arch bar prosthesis during vertical load application. Materials and methods: A milled cross‐arch metal framework supported by four implants in a trapezoidal design was supported in polymethylmethacrylate. T‐strain gage rosettes were attached to the crestal areas of the implants with two grids, one recording circumference strain of the crestal area of the implant and the second recording vertical strain, torquing strains of the implant. The framework was subject to vertical loading from an MTS 810 mechanical system. Loading sites were directly on anterior and posterior implants, and on a cantilever at 7.5, 15, 22.5, and 30 mm (0.5, 1.0, 1.5, and 2.0 of the anterior–posterior spread) distal from the posterior implant on the right side. The anterior–posterior (A–P) spread from anterior to posterior implants was 15 mm. Sites were loaded individually with 50 and 100 N. The data from the rosettes were transferred to a desktop computer and processed using StrainSmart 5000 software. Results: Means and standard deviations were calculated for the 10 trials at each of the loading sites. Two‐way ANOVAs were done separately for each dependent variable, the vertical grid, and the circumferential grid. The independent variables were the load magnitude and the load site. Tukey's test was used to compare groups post hoc. When directly loading the implants, loading the anterior implant resulted initially in compression followed by increasing tensile strain with 100 N loads. Loading the implant adjacent to cantilever (the posterior implant) resulted in greater strain at the collar than that observed with anterior implant with minimal bending strains. When loading the cantilever, anterior implant showed increasing bending strain at greater cantilever length, whereas the circumferential strains were greater for the supporting implant adjacent to the cantilever, particularly at 100 N loads, p ≤ 0.001. Conclusions: Limiting cantilever lengths to A–P spread ratios of 0.5 are preferred. Ratios greater than 1.0 should be avoided as flexing of the collar may occur. The dimensions of the implant, particularly wall thickness, adjacent to the cantilever should be carefully considered when planning the cantilevered implant‐supported prosthesis. [ABSTRACT FROM AUTHOR]

Background.: A key factor for the success or failure of an implant is how the stresses are transferred to the surrounding bone. The implant‒abutment connection (IAC) is paramount for implant success. The purpose of this finite element analysis (FEA) study was to evaluate the stress distribution in and around three different implant‒abutment interfaces with platform-switched and platform-matched abutments using the finite element method (FEM). Methods.: Three distinct types of IAC were selected: tri-channel internal connection, conical connection, and internal hex connection. Six models were generated, three in platform-switched and three in non-platform-switched configuration. Computer-Aided Three-Dimensional Interactive Application (CATIA) V5 R20 software was used to generate virtual models of the implants and the mandible. The models were transferred to Analysis of Systems (ANSYS) 15.0 software, in which the models were meshed and underwent FEA. Results.: On the crestal bone, the highest von Mises stresses in platform-switched abutments were noticed in the internal hex implant‒abutment system (370 MPa), followed by the tri-channel implant‒abutment system (190 MPa) and conical implant‒abutment system (110 MPa). On the implant and the abutment screw, the highest von Mises stresses were observed in the internal hex implant‒abutment system, followed by the conical implant abutment system and tri-channel implant‒abutment system. Platform-switched implants had a more favorable stress distribution on crestal bone. Conclusion.: Within the constraints of the current study, the internal hex connection exhibited the highest stress. In contrast, the conical abutment connection with platform switching configuration had more favorable stress distribution in crestal bone than other implant abutment systems. [ABSTRACT FROM AUTHOR]

Copyright of Dental Press Endodontics is the property of Dental Press International and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aim: This study assessed the effect of crown dimensions on stress distribution in the abutment screw upon loading using three-dimensional (3D) finite element analysis (FEA). Materials and Methods: Eighteen finite element models were designed using Mimics, 3D-Matic, Catia, and ANSYS software programs. Implant models were designed with 8.5-, 10- and 11.5-mm fixture heights, three different vertical cantilever heights of 8, 10, and 12 mm, and two horizontal cantilever lengths of 7 and 14 mm for the mandibular first and second molars. The interaction effect of of 120 N and 20 N loads on the implant and implant crown at the site of first molar, and the interaction effect of 150 N and 25 N loads on the cantilever at the site of second molar were analyzed. Results: By an increase in horizontal cantilever length, stress in the abutment screw, abutment, and fixture increased in all models. Stress decreased in the abutment screw and increased in the abutment and fixture by an increase in vertical cantilever. Minimum screw stress was recorded in implants with 8.5 mm fixture height, 7 mm horizontal cantilever, and 12 mm vertical cantilever. Maximum screw stress was noted in implants with 11.5 mm fixture height, 14 mm horizontal cantilever, and 8 mm vertical cantilever. Conclusion: According to FEA, increasing the horizontal and vertical cantilever length may result in an increased risk of screw loosening and fatigue fracture due to increased stress values in the screw or in other components (abutment and fixture), respectively.

Copyright of Brazilian Dental Science is the property of Brazilian Dental Science Journal-ICT-UNESP and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Silver diamine fluoride (SDF) has been used as a caries arresting agent. The application protocol of SDF is unclear. Some clinicians prefer to light cure SDF to accelerate the hardening of SDF; however, the effect of the same on bond strength of the restoration is unknown. This study aimed to determine the effect of light-curing SDF on microtensile bond strength (µTBS) of primary teeth restored with glass ionomer cement (GIC). Materials and Methods: Seventeen carious primary molars were sectioned through the middle of the carious lesion and allocated randomly to three groups. Group 1—SDF application followed by GIC restoration, group 2—SDF application followed by light cure of SDF and restored with GIC, group 3—control: GIC restoration without SDF application (n = 11). The samples were stored in artificial saliva; evaluated for µTBS under universal testing machine until failure. The failure mode was evaluated using stereomicroscope at 40× magnification. Results: µTBS of the groups were compared using Kruskal–Wallis test, which showed a statistically significant difference between the groups (P < 0.05). Dunn’s post hoc test revealed a significantly higher bond strength with group 2 (4.15 ± 2.51) compared to group 1 (1.40 ± 0.49) (P value 0.022). The failure modes for each group were carried out with chi-square test which revealed no statistically significant difference. Conclusion: Light-curing SDF prior to application of GIC resulted in significantly greater bond strength when compared to non–light-cured SDF.

Background/Aim. In implant prosthetics, there is an increasing use of materials that, with their mechanical characteristics, can alleviate the negative consequences of implant stress. The aim of this study was to conduct a comparative analysis of stress distribution and deformation of implant-supported telescopic systems and surrounding structures made of different materials using the finite element method. Methods. The 3D finite element models were prepared using the SolidWorks program (SolidWorks 2018, Concord, MA, USA). Two models of telescopic crowns with the characteristics of polyetherether-ketone (PEEK) polymer and cobalt-chromium (Co-Cr) alloy faceted with feldspar ceramics were used. The models were loaded with an axial force of 150 N in the region of the central fossa. The analysis of stress and strain distribution was per-formed by the finite element method in the Ansys software (ANSYS Workbench 16; Ansys Inc., Pittsburg, PA, USA). Results. Implant-supported telescopic crowns made of PEEK polymer significantly reduced stress in the implant and abutment neck area compared to the conventional Co-Cr crown veneered ceramic. At the level of bone structure, both models showed a concentration of stress at the level of the cortical bone, while the trabecular bone was significantly less exposed to stress. Under the same conditions, the degree of deformation of the secondary telescopic crown was more pronounced in models with PEEK polymer characteristics. Conclusion. Owing to their mechanical characteristics, PEEK polymers can be the materials of choice in the fabrication of superstructures on implants. Given that this in vitro study was accompanied by limitations, further research is needed to confirm the superior role of PEEK material in implant prosthetics.

Objectives: One of the most common methods used for the reconstruction of endodontically treated teeth is post and core and crown. Various factors such as the remaining tissue above the cutting margin (ferrule) affect the fracture resistance of teeth restored with post and core and crown. This study aimed to investigate the effect of ferrule/crown ratio (FCR) on the strength of maxillary anterior central teeth using finite element analysis. Materials and Methods: A 3D scan of a central incisor was obtained, and the data were transferred to Mimics software. Then, a 3D model of the tooth was designed. Next, 300N load was applied at a 135° angle to the tooth model. Force was applied to the model both horizontally and vertically. Ferrule height was considered to be 5%, 10%, 15%, 20%, and 25% in the palatal surface and 50% in the buccal surface. The length of post in the model was 11, 13, and 15mm. Results: By increasing the FCR, stress and strain distribution increased in the dental model and decreased in the post itself. As the horizontal angle of load application increased, the level of stress and strain created in the dental model increased as well. The closer the force application site to the incisal area, the higher the stress and strain would be. Conclusion: Maximum stress was inversely correlated with FCR and post length. In ratios of 20% and higher, insignificant changes occurred in stress and strain patterns in the dental model. [ABSTRACT FROM AUTHOR]

Debonding of zirconia cantilevered resin-bonded fixed dental prostheses (RBFDPs) remains the main treatment complication, therefore, the present in vitro study aimed to evaluate the effect of different surface pretreatments on the bonding of zirconia RBFDPs. Eighty milled zirconia maxillary central incisors, with complementary zirconia cantilevered RBFDPs, were randomly subjected to four different surface pretreatments (n = 20): as-machined (AM); airborne-particle abraded (APA); coated with nanostructured alumina coating (NAC); incisor air-abraded and RBFDP coated (NAC_APA). After bonding, half of each group (n = 10) was stored in deionized water (150 days/37 °C), thermocycled (37,500 cycles, 5–55 °C), and cyclically loaded (50 N/1.2 × 106). Load-bearing capacity (LBC) was determined using a quasi-static test. Additionally, finite element analysis (FEA) and fractography were performed. t-test and one-way ANOVA were used for statistical-analysis. Before aging, the NAC group provided superior LBC to other groups (p < 0.05). After aging, the AM specimens debonded spontaneously, while other groups exhibited comparable LBC (p ˃ 0.05). The FEA results correlated with the in vitro experiment and fractography, showing highly stressed areas in the bonding interface, cement layer, and in RBFDP's retainer wing and connector. The NAC RBFDPs exhibited comparable long-term bonding performance to APA and should be regarded as a zirconia pretreatment alternative to APA. [ABSTRACT FROM AUTHOR]

The aim of this review was to provide an update on the current status of digital occlusal force measurement devices, as well as clinical and research applications in complete arch maximum occlusal force measurement. SCOPUS, ScienceDirect, and PubMed databases were used to conduct a literature search from January 2001 to January 2021. Identification and screening of literature were done independently according to published guidelines and selection criteria. The electronic searches turned up 394 articles, 16 of which met the inclusion and exclusion criteria and were selected for study analysis. All of these studies used T-scan and Dental Prescale digital occlusal analysis system with pressure-sensitive foils as occlusal force measurement devices. The devices showed a promising potential for identifying and comprehending maximum occlusal forces objectively. According to the current review, maximum occlusal force measured with digital occlusal force devices can be used as a prosthodontic adjunct to address issues that arise during the treatment of occlusal disorders, temporomandibular disorders, and complete dentures. It is also useful in predicting cognitive and functional decline in the elderly. [ABSTRACT FROM AUTHOR]

The restoration of endodontically treated teeth is one of the main challenges of restorative dentistry. The structure of the tooth is a complex assembly in which the materials that make it up, enamel and dentin, have very different mechanical behaviors. Therefore, finding alternative replacement materials for dental crowns in the area of restorative care isa highly significant challenge, since materials such as ceramic and zirconia have very different stress load resistance values. The aim of this study is to assess which material, either ceramic or zirconia, optimizes the behavior of a restored tooth under various typical clinical conditions and the masticatory load. A finite element analysis (FEA) framework is developed for this purpose. The 3D model of the restored tooth is input into the FEA software (Ansys Workbench R23)and meshed into tetrahedral elements. The presence of masticatory forces is considered: in particular, vertical, 45° inclined, and horizontal resultant forces of 280 N are applied on five contact points of the occlusal surface. The numerical results show that the maximum stress developed in the restored tooth including a ceramic crown and subject to axial load is about 39.381 MPa, which is rather close to the 62.32 MPa stress computed for the natural tooth; stresses of about 18 MPa are localized at the roots of both crown materials. In the case of the zirconia crown, the stresses are much higher than those in the ceramic crown, except for the 45° load direction, while, for the horizontal loads, the stress peak in the zirconia crown is almost three times as large as its counterpart in the ceramic crown (i.e., 163.24 MPa vs. 56.114 MPa, respectively). Therefore, the zirconia crown exhibits higher stresses than enamel and ceramic that could increase in the case of parafunctions, such as bruxism. The clinician’s choice between the two materials should be evaluated based on the patient’s medical condition.

Introduction: the use of custom implants is a very common treatment; we assess and compare their behavior against that of conventional implants. This study aimed to make sure that the stress zones of the custom implant are different from those presented by the conventional prefabricated implant by photoelasticity. Methods: we subjected samples of n=10 bicuspid teeth, n=10 sintered custom implants, and n=10 conventional prefabricated implants to 3 fixed and controlled forces and observed the samples through a polariscope to analyze the distributions of effort generated. The effort zones present in the different samples were analyzed under 3 different forces. Results: the amounts of effort in the two types of implants under force 1 (chi-square test, p=0.596) are different, as is also the case under force 2 (chi-square test, p=0.407). Under force 3 (Levene test, p=0.899), there is no difference in the distributions of effort between the two types of implants. Conclusions: it was determined that the conventional prefabricated implant distributes and concentrates the effort generated under different forces better than the sintered custom implant.

Objectives: One of the most common methods used for the reconstruction of endodontically treated teeth is post and core and crown. Various factors such as the remaining tissue above the cutting margin (ferrule) affect the fracture resistance of teeth restored with post and core and crown. This study aimed to investigate the effect of ferrule/crown ratio (FCR) on the strength of maxillary anterior central teeth using finite element analysis. Materials and Methods: A 3D scan of a central incisor was obtained, and the data were transferred to Mimics software. Then, a 3D model of the tooth was designed. Next, 300N load was applied at a 135° angle to the tooth model. Force was applied to the model both horizontally and vertically. Ferrule height was considered to be 5%, 10%, 15%, 20%, and 25% in the palatal surface and 50% in the buccal surface. The length of post in the model was 11, 13, and 15mm. Results: By increasing the FCR, stress and strain distribution increased in the dental model and decreased in the post itself. As the horizontal angle of load application increased, the level of stress and strain created in the dental model increased as well. The closer the force application site to the incisal area, the higher the stress and strain would be. Conclusion: Maximum stress was inversely correlated with FCR and post length. In ratios of 20% and higher, insignificant changes occurred in stress and strain patterns in the dental model.

This study aimed to compare the intracanal lateral force and cutting efficiency associated with two engine-driven nickel-titanium (NiTi) systems during root canal shaping. Bovine single-rooted teeth models were assembled to a custom-made splitting force measuring platform while being endodontically treated with rotary (ProTaper Gold [PTG]) or reciprocal systems (WaveOne Gold [WOG]) by two clinicians. The cutting efficiency test was run for each group by a free-falling endomotor on dentin discs for 3 min. The resulting force, files, and stroke force peaks were recorded. Data were analyzed by the Shapiro-Wilk test and ANOVA. Statistical significance was set at alpha = 0.05. Intracanal lateral forces (p < 0.01), cutting efficiency (p < 0.01), and time efficiency (p < 0.01) were significantly different between the NiTi groups. The maximum lateral splitting force was detected using the PTG shaping full-length file (S1) and during the WOG final stroke. Thus, caution is advised when reciprocating single-file systems approach the apical third or when using a large taper and wide-diameter rotatory instruments. The WOG had significantly less maximum horizontal splitting force and significantly greater cutting efficiency but less time efficiency than the PTG system. [ABSTRACT FROM AUTHOR]

Introduction: Silver diamine fluoride (SDF) has been used as a caries arresting agent. The application protocol of SDF is unclear. Some clinicians prefer to light cure SDF to accelerate the hardening of SDF; however, the effect of the same on bond strength of the restoration is unknown. This study aimed to determine the effect of light-curing SDF on microtensile bond strength (µTBS) of primary teeth restored with glass ionomer cement (GIC). Materials and Methods: Seventeen carious primary molars were sectioned through the middle of the carious lesion and allocated randomly to three groups. Group 1--SDF application followed by GIC restoration, group 2--SDF application followed by light cure of SDF and restored with GIC, group 3--control: GIC restoration without SDF application (n =11). The samples were stored in artificial saliva; evaluated for µTBS under universal testing machine until failure. The failure mode was evaluated using stereomicroscope at 40× magnification. Results: µTBS of the groups were compared using Kruskal-Wallis test, which showed a statistically significant difference between the groups (P < 0.05). Dunn's post hoc test revealed a significantly higher bond strength with group 2 (4.15 ± 2.51) compared to group 1 (1.40 ± 0.49) (P value 0.022). The failure modes for each group were carried out with chi-square test which revealed no statistically significant difference. Conclusion: Light-curing SDF prior to application of GIC resulted in significantly greater bond strength when compared to non-light-cured SDF. [ABSTRACT FROM AUTHOR]

No evidence-based prosthetic treatment concept for 3-unit fixed-dental-prostheses (FDPs) on ceramic implants is currently available. Therefore, the aim of this in vitro study was to investigate the failure load and fatigue behavior of monolithic and bi-layer zirconia FDPs supported by one-piece ceramic implants. Eighty 3-unit FDPs supported by 160 zirconia-implants (ceramic.implant; vitaclinical) were divided into 4 groups (n = 20 each): Group Z-HT: 3Y-TZP monolithic-zirconia (Vita-YZ-HT); Group Z-ST: 4Y-TZP monolithic-zirconia (Vita-YZ-ST); Group FL: 3Y-TZP zirconia (Vita-YZ-HT) with facial-veneer (Vita-VM9); Group RL (Rapid-layer): PICN "table-top" (Vita-Enamic), 3Y-TZP-framework (Vita-YZ-HT). Half of the test samples (n = 10/group) were fatigued in a mouth-motion chewing-simulator (F = 98 N, 1.2 million-cycles) with simultaneous thermocycling (5–55 °C). All specimens (fatigued and non-fatigued) were afterwards exposed to single-load-to-failure-testing (Z010, Zwick). Statistical analysis was performed using ANOVA, Tukey's post-hoc tests and two-sample t-tests (p < 0.05, Bonferroni-corrected where appropriate). All specimens withstood fatigue application. While the effect of fatigue was not significant in any group (p = 0.714), the choice of material had a significant effect (p < 0.001). Material FL recorded the highest failure loads, followed by Z-ST, Z-HT and RL, both with and without fatigue application. Taken together, all tested FDP material combinations survived chewing forces that exceeded physiological levels. Bi-Layer FL and monolithic Z-ST showed the highest resilience and might serve as reliable prosthetic reconstruction concepts for 3-unit FDPs on ceramic implants. [ABSTRACT FROM AUTHOR]

The long-term success and predictability of implant-supported restorations largely depends on the biomechanical forces (stresses) acting on implants and the surrounding alveolar bone in the mandible. The aim of our study was to investigate the biomechanical behavior of an edentulous mandible with an implant-supported full bridge on four implants under simulated masticatory forces, in the context of different loading schemes, using a three-dimensional finite element analysis (3D-FEA). A patient-specific 3D finite element model was constructed using pre- and post-implantation computer tomography (CT) images of a patient undergoing implant treatment. Simplified masticatory forces set at 300 N were exerted vertically on the denture in four different simulated load cases (LC1–LC4). Two sets of simulations for different implants and denture materials (S1: titanium and titanium; S2: titanium and cobalt-chromium, respectively) were made. Stress outputs were taken as maximum (Pmax) and minimum principal stress (Pmin) and equivalent stress (Peqv) values. The highest peak Pmax values were observed for LC2 (where the modelled masticatory force excluded the cantilevers of the denture extending behind the terminal implants), both regarding the cortical bone (S1 Pmax: 89.57 MPa, S2 Pmax: 102.98 MPa) and trabecular bone (S1 Pmax: 3.03 MPa, S2 Pmax: 2.62 MPa). Overall, LC1—where masticatory forces covered the entire mesio−distal surface of the denture, including the cantilever—was the most advantageous. Peak Pmax values in the cortical bone and the trabecular bone were 14.97–15.87% and 87.96–94.54% higher in the case of S2, respectively. To ensure the long-term maintenance and longevity of treatment for implant-supported restorations in the mandible, efforts to establish the stresses of the surrounding bone in the physiological range, with the most even stress distribution possible, have paramount importance.

Objectives: The purpose of this study was to evaluate the effects of different resin-based and ceramic superstructure materials and two different abutment types on the stress distribution of the abutment screw using the three-dimensional finite element stress analysis method. Materials and Methods: A three dimensional implant, abutment (zirconia and titanium), abutment screw, crown (zirconia reinforced lithium silicate, lithium disilicate, polymer-infiltrated resin ceramic, and PEEK), and alveolar bone were designed using Rhinoceros 3D modeling software and VRMesh Studio software and combined to form 8 simulations. On the models prepared, loading was made on the lingual tubercule of the maxillary right first premolar crown at an angle of 30° with 150 N force obliquely in the buccolingual direction. The von Mises values obtained from the abutment screw were compared according to the types of abutment and crown materials. Results: The von Mises stress values in the abutment screw were higher in the models using a titanium abutment abutment (on average 1336.24 MPa), and the lower stress values were obtained in the models using a zirconia abutment (on average 964.26 MPa). When the prosthetic material used was changed, no apparent difference was observed in the stress values on the abutment screw. Conclusions: Considering that the abutment screw is the weakest link of the implant system, zirconia abutments can be used reliably in the maxillary first premolar region where aesthetic expectations are high.

The load-bearing dentoalveolar fibrous joint is composed of biomechanically active periodontal ligament (PDL), bone, cementum, and the synergistic entheses of PDL-bone and PDL-cementum. Physiologic and pathologic loads on the dentoalveolar fibrous joint prompt natural shifts in strain gradients within mineralized and fibrous tissues and trigger a cascade of biochemical events within the widened and narrowed sites of the periodontal complex. This review highlights data from in situ biomechanical simulations that provide tooth movements relative to the alveolar socket. The methods and subsequent results provide a reasonable approximation of strain-regulated biochemical events resulting in mesial mineral formation and distal resorption events within microanatomical regions at the ligament-tethered/enthesial ends. These biochemical events, including expressions of biglycan, decorin, chondroitin sulfated neuroglial 2, osteopontin, and bone sialoprotein and localization of various hypertrophic progenitors, are observed at the alkaline phosphatase-positive widened site, resulting in mineral formation and osteoid/cementoid layers. On the narrowed side, tartrate-resistant acid phosphatase regions can lead to a sequence of clastic activities resulting in resorption pits in bone and cementum. These strain-regulated biochemical and subsequently biomineralization events in the load-bearing periodontal complex are critical for maintenance of the periodontal space and overall macroscale joint biomechanics.

Objectives: The purpose of this study was to systematically review the literature and use meta-analysis to investigate whether chlorhexidine (CHX) application after acid etching as an adjunct treatment has any influence on the immediate and delayed bond strength to primary dentin. Materials and Methods: In this review, PubMed, ISI (all data bases), Scopus and Cochrane were searched according to the selected keywords up to April 30, 2018. The full texts of all published articles that met our primary inclusion criteria were obtained. The studies were analyzed in two parts: in vitro studies that evaluated the effect of CHX application during the bonding procedures (application after acid etching) on immediate and delay dentin bond strength of resin-dentin interface. Results: The initial search yielded 214 publications, of which 8 were selected after thorough methodological assessment. None of the clinical studies fulfilled the eligibility criteria. Our results indicated that in comparison to the control group, CHX significantly reduced immediate resin-dentin bond strength (P=0.043). These values were increased after aging (P

(1) Background: The paper addresses the computer simulation and prediction of the service life of the base of removable complete dentures (RCDs) under typical loads caused by biting and chewing food. For this purpose, the finite element method (FEM) was used. It is assumed that various blocks of teeth, such as incisors, canines, premolars and molars, are subjected to cyclic impacts during a human life. (2) Methods: Both symmetric and asymmetric mastication (two- and one-sided loads, respectively) cases were considered. The load level was assumed to be 100 N, which corresponds to the average muscular compression force of typical human jaws. (3) Results: The FEM analysis of the stress–strain state evolution for RCDs under cyclic loads was carried out. Maps of equivalent lines were drawn for the denture base in terms of its durability. A multi-axial criterion was implemented to determine the number of cycles prior to failure by the mechanism of a normal opening mode crack. The FEM-based assessment of the service life of RCDs enabled us to establish the critical stress concentration areas, thereby allowing for further planning for the correction of an occlusal scheme or teeth inclinations. As a result, the service life of RCDs under cyclic loading can be improved. (4) Conclusions: An algorithm for designing RCDs in the case of edentulism based on the FEM simulation using commercial software as part of the procedure is proposed. [ABSTRACT FROM AUTHOR]

This study uses fracture tests and fractographical analysis to compare computer-aided design and computer-aided manufacturing (CAD/CAM) lithium disilicate molar crowns with the previous occlusal thickness recommendation of 1.5-mm, the new recommendation of 1.0-mm, and a less invasive thickness of 0.8-mm. After fatigue application, fracture tests and fractographic analysis were conducted. The fracture resistance of CAD/CAM lithium disilicate molar crowns was different depending on the occlusal thickness of the restoration, and decreased with lower the thickness. However, the fracture resistance of crowns of all three thicknesses exceeded the reported maximum bite force in the first molar region after the fatigue process, and can be considered acceptable for use in the clinic. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study is to evaluate the effect of 7 different desensitizing agents on the shear bond strength (SBS) of zirconia restorations to dentin with a self-adhesive resin cement and determine the failure modes., Methods: Eighty molars' occlusal surfaces were ground to expose dentin and were randomly divided into 8 groups (n = 10): 1. Gluma (HEMA/Glutaraldehyde) 2. Bifluoride (Sodium Fluoride/Calcium Fluoride) 3. Admira (Bis-GMA/HEMA) 4. Smart Protect (Glutaraldehyde) 5. Teethmate (Tetracalcium phosphate, Dicalcium phosphate) 6. Clinpro White (Sodium fluoride) 7. BisBlock (Oxalic acid) and 8. Control (No-treatment). After applying the agent, a self-adhesive resin cement (Rely-X U200) was used to lute zirconia discs (4 mm height and 4 mm diameter) to dentin. After stored in distilled water at 37 °C for 24 h, all groups were thermocycled for 2500 cycles between 5 ± 2 °C and 55 ± 2 °C. Specimens were submitted to SBS test with a universal testing machine at a crosshead speed of 0.5 mm/min until failure. SBS values were compared with ANOVA. Post-hoc multiple comparisons were performed with Dunnett T3. The failure modes of specimens were examined with stereomicroscope at a magnification of 20X and the distribution of the failure modes were evaluated with Pearson Chi-Square test., Results: Regarding mean SBS values in MPa's; Admira (10.70 ± 3.99), Smart Protect (9.62 ± 3.93), and Gluma (8.90 ± 3.76) treatments showed higher SBS values compared to control group (p < .05) according to ANOVA. The SBS values of Teethmate (5.31 ± 2.37) and Clinpro White (4.32 ± 2.44) were higher than control group but the difference was not found significant (p > .05). BisBlock (2.33 ± 1.94) and Bifluouride (1.60 ± 1.47) groups showed the lowest SBS values but their difference between control group was not found statistically significant (p > .05). Most specimens showed adhesive failure but no statistically significant difference was found in the distributions of failure modes according to Chi-square test., Conclusion: Within the limitation of the study; Admira, Smart Protect, and Gluma increased the SBS of the zirconia restorations to dentin and can be recommended to use on prepared dentin surfaces prior to the cementation., Competing Interests: Declarations Ethics approval and consent to participate The present study was accepted by the Ege University Medical Faculty Clinical Researches Ethics Committee with decision number 15 − 9.1/11 on 26 October 2015. The authors declare that informed patient consent was provided from the involved patients. Consent for publication Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Objective: This study aimed to systematically review the effect of laser treatment on the bond strength of epoxy resin-based and calcium silicate-based endodontic sealers to root dentine., Methods: The search encompassed four databases: PubMed/MEDLINE, EMBASE, Scopus, and ISI Web of Science. Inclusion criteria were limited to in vitro studies conducted on extracted human teeth evaluating bond strength in megapascals (MPa) of either epoxy resin-based or calcium silicate-based sealers, using the push-out test. Two independent reviewers appraised the methodological quality of the selected studies to assess the risk of bias. Meta-analysis was performed for different laser types, endodontic sealers, and control groups. Standard Mean Difference and 95% Confidence Interval values were calculated., Results: 17 studies met the inclusion criteria for qualitative synthesis, and 15 for quantitative analysis. Meta-analyses revealed that certain lasers (Er,Cr:YSGG, Er:YAG) significantly increased bond strength for epoxy resin-based sealers when compared to negative controls (inert solutions), but did not show a significant advantage over EDTA agent. For calcium silicate-based sealers, laser treatment did not show significant enhancement in bond strength compared to either inert solutions or EDTA. The subgroup analysis suggested that erbium lasers, especially in the PIPS mode, potentially increase the bond strength of epoxy resin-based sealers., Conclusion: Laser treatment enhances the bond strength of epoxy resin-based sealers compared to inert solutions, but not more than EDTA. For calcium silicate-based sealers, laser treatment does not significantly improve bond strength over inert solutions or EDTA., Clinical Relevance: Laser treatment increases the bond strength of epoxy resin-based sealers., Competing Interests: Declarations Competing interests The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study is aimed to investigate the types of knot failure (untying or breaking) and the tension required to break different suture diameters. A total of 150 knots were fabricated using polyamide sutures with diameters of 6/0, 7/0, and 8/0. The studied knots were either squared or slipped with different numbers of throws (2, 3, 4, 5, and 6), and the following data were recorded: type of failure (untied or broken), number of throws, the tension required to untie or break each knot, slippage, and elongation of the knot. The knots were created in a standardized way with a device and weights, then subjected to a controlled tension. The knots that became untied were: 1=1, 1×1, 2=1, and 2×1, whereas the remaining knots broke. Notably, at least three throws were required to prevent untying, but separately, as in 1=1=1 or 1×1×1. The mean tension needed to break the knots in 6/0, 7/0, and 8/0 sutures were 3.1, 1.3, and 0.6 N, respectively (P < .05), and they were independent of the knot type. The results from this study demonstrate that the knots with geometries of 2=2/2×2 and 1=1=1/1×1×1 were secure, and having additional throws does not increase their security. Further, tensile strength reduces with decreased suture size.

Objectives: To assess the influence of different primer compositions-silane (S), 10-methacryloyloxydecyl dihydrogen phosphate (MDP), and the combination of silane and MDP (S + MDP)-on the bonding performance of MDP-free and MDP-containing resin cements to highly translucent zirconia., Materials and Methods: Tribochemical silica-coated zirconia plates were pretreated with one of three experimental primers, S, MDP, or S + MDP, with untreated specimens serving as controls. Subsequently, these plates were bonded to stainless-steel rods using either two MDP-free or two MDP-containing resin cements. Tensile bond strength was measured after 24 h (TC0) and following thermal cycling (4-60 °C for 10,000 cycles; TC10,000). Data were analyzed using a three-way analysis of variance (ANOVA), followed by one-way ANOVA and Tukey-Kramer post hoc tests (α = 0.05). X-ray photoelectron spectroscopy (XPS) assessed the elemental mass concentrations on the zirconia surfaces., Results: For MDP-free resin cements, MDP-treated specimens exhibited significantly greater bond strengths than controls, regardless of the aging conditions. However, a significant reduction in bond strength was observed between TC0 and TC10,000 in most of the MDP-free resin cement groups, except for one S + MDP group. Conversely, for MDP-containing resin cements, the S + MDP group exhibited no statistically significant differences between aging conditions. Notably, XPS analysis detected silicon, zirconium, and aluminum on the zirconia surfaces., Conclusions: No significant difference in tensile bond strength was observed between aging conditions for MDP-containing resin cements bonded to tribochemical silica-coated zirconia primed with S + MDP., Clinical Relevance: The combination of MDP-containing primers and resin cements demonstrated superior bonding performance to tribochemical silica-coated zirconia., Competing Interests: Declarations Ethics approval and consent to participate Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: The objective of this study is to evaluate the effectiveness of two different viscosities of short fiber-reinforced composite resin (SFRC) cores and two different viscosities of veneering composite resins on the fracture strength of direct occlusal veneers., Materials and Methods: One maxillary premolar was virtually prepared for an occlusal veneer and printed into resin dies. In total, (n = 48) resin dies were printed and assigned into three groups according to the type of core material of the occlusal veneer; mono-structured without a SFRC core, a high viscosity SFRC core, and a low viscosity SFRC core. Each group was re-divided into two subgroups (n = 8) according to the veneering composite resin; packable composite resin and injectable composite resin. Mono-structured and bi-structured direct occlusal veneers were fabricated on the resin dies using the mentioned core and veneering materials with the occlusal replica technique. Fracture strength was evaluated using a universal testing machine and the mode of failure was inspected. Statistical analysis to compare the core and veneering materials was performed using independent t test (P ≤ 0.05) and one-way ANOVA followed by tukey's post hoc test (Pa ≤ 0.0166) when appropriate. Interactions between subgroups were tested using two-way ANOVA, and one-way ANOVA was used to compare all subgroups followed by tukey's post hoc test (Pa ≤ 0.0033). Intergroup comparison between failure modes were performed using chi square test (Pa ≤ 0.0033)., Results: The presence of a SFRC core significantly improved the fracture strength of the specimens. There was no significant difference between the fracture strength of high viscosity SFRC and low viscosity SFRC cores. Specimens veneered with injectable composite resin had significantly superior fracture strength compared to packable composite resin. Additionally, there was a weak correlation between fracture strength and mode of failure., Conclusion: Short fiber reinforced composite resin significantly increases the fracture strength of direct occlusal veneers. Injectable composite resin has significantly higher fracture strength than packable composite resin as veneering materials of direct occlusal veneers., Clinical Relevance: Bi-structured direct occlusal veneers fabricated of injectable composite resin with low viscosity SFRC cores can withstand high masticatory forces in stress-bearing areas., Competing Interests: Declarations Ethics approval and consent to participate This study did not include any human participants, the human premolar tooth used in this study was extracted for orthodontic purposes and obtained with the approval of the Research ethics committee of Ain Shams University (FDASU) whom exempted this study (file number: FDASU-Rec EM012349) in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Objective: To evaluate the effect of polyetheretherketone (PEEK) periodontal splints and splints made from other materials under static loading on stress distributions in periodontal tissues, cement layer, and splints themselves. Methods: A finite element model based on cone-beam CT imaging data of a 25-year-old male patient (treated at the Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University in October 2021 for a cracked maxillary molar) with a healthy and intact mandibular dentition and periodontal health was constructed. The finite element model included anterior mandible dentition, mandibular bone model without bone resorption (WBR group), a periodontally compromised mandible model (control group), and three types of periodontal splints: a PEEK periodontal splint (0.7 mm thick, Young's modulus: 4.1 MPa), a fiber-reinforced resin (FRC) splint (1.0 mm thick, Young's modulus: 37.0 MPa), and a titanium splint (1.2 mm thick, Young's modulus: 110.0 MPa). The bone resorption models fixed with different periodontal splints constituted the experimental groups (PEEK group, FRC group and titanium group). Loading of 100 N was applied on the midpoint of the incisal edge of tooth 41. The direction was set at 0°, which was parallel to the long axis of the tooth and downward. The buccal to lingual and downward angles were 30°and 60°, respectively, perpendicular to the long axis of the tooth and 90° to the lingual side. The finite element analysis software was utilized to analyze the stress distribution characteristics of the periodontal tissues, adhesive layer, and the splint itself in the anterior mandibular teeth among the different group. Results: Under the different loading simulation, in the control group, the maximal von Mises stresses of periodontal ligament and bone were 15.7-50.2 MPa and 38.8-130.3 MPa, respectively, and in the WBR group, the maximal von Mises stresses of periodontal ligament and bone were 3.6-6.4 MPa and 16.5-42.7 MPa, respectively. Under the same loading conditions, the magnitude of maximal von Mises stresses in periodontal tissues in the PEEK group was 4.6-6.2 MPa, and the magnitude of stresses in the periodontal ligament of 41 teeth in the WBR group was similar to that in the PEEK group, but higher than that in the FRC and titanium groups. The maximal von Mises stresses of each group is primarily distributed in the periodontal ligament and alveolar bone at the cervical area of the tooth. The higher the elastic modulus of the splint, the higher its own maximal von Mises stresses, and the smaller the maximal principal stresses transmitted to the adhesive layer. In the PEEK group and titanium group, the stress distribution area in the adhesive layer and the splint was near the splint connection adjacent to tooth 41. Conclusions: Periodontal splints fabricated from three types of materials, are effective in distributing stress within the periodontal tissues of the abutment teeth. Compared to FRC and titanium group, the higher PEEK splint stress value was obtained, and the smaller the stress value was transmitted to its adhesive layer.

Objectives: The study investigated the influence of retention grooves and material thickness of the retainer wing on the retentive strength of resin-bonded attachments (RBAs)., Materials and Methods: Sixty-four extracted human molars were used. Each tooth received a preparation limited to the enamel for the retainer wings of the RBAs. The specimens were divided into eight groups, each containing eight specimens. The groups varied based on the number of conical retention grooves (0, 1, 2, or 4) and the thickness of the CoCr retainer wings (0.4 mm and 0.8 mm). Before testing the retentive strength of the RBAs, the specimens underwent 37,500 thermal cycles followed by dynamic loading of 1,200,000 cycles on the RBAs' patrices using a chewing simulator. The debonding test was conducted using a universal testing machine at a crosshead speed of 2 mm/min., Results: The mean retentive strength ranged from 326 ± 96 N to 440 ± 77 N. Only a small portion of specimens (10.9%) exhibited adhesive failure, while the remainder demonstrated cohesive failure within the tooth structure. Neither the number of retention grooves, the thickness of the retainer wings, nor the size of the bonding surface significantly affected retentive strength., Conclusions: The findings suggest that reducing the number of retention grooves and the material thickness does not influence the retentive strength of RBAs., Clinical Relevance: The retention of RBAs appears promising, supporting the clinical application of this treatment modality., (© 2024. The Author(s).)

Aim: to assess and compare the effect of mid-root perforation repair using Biodentine and Portland cement in single-rooted endodontically treated mandibular premolars in terms of stress distribution using finite element analysis (FEA) and fracture resistance test., Methods: In the FEA, an extracted human mandibular premolar tooth was scanned using cone beam computed tomography, and a 3-dimensional (3D) solid model was created. A sound tooth model (ST), an endodontically treated model (ET), an instrumented and mid-root perforated and repaired by Biodentine model (BM), and perforated and repaired by Portland cement model (PCM) were the 4 models simulated. A vertical force of 300 N on the occlusal plane was applied. Evaluation of von Mises stress distribution and maximum displacement were investigated. In the fracture resistance in vitro study, 28 extracted premolars were selected and randomized into 4 groups, (n = 7), (A) is the negative control intact group, (B) is the positive control of endodontically treated group, (C) is mid-root perforated and repaired by Biodentine group and (D) is mid-root perforated and repaired by Portland cement. All Teeth were instrumented except for group A, group B was obturated while groups C and D were instrumented, perforated, repaired, and obturated. All groups were restored coronally except group A. Fracture force was measured; subsequently, the fracture repairability was evaluated. Finally, the data were statistically evaluated using one-way analysis of variance (ANOVA); the significance level was set at P ≤ 0.05 and the repairability of teeth after fracture was correlated to the maximum loading using Pearson's coefficient tests., Results: In FEA, Maximum von Mises stress was descending assorted as 121.1 MPa for ET, 115.6 MPa for BM and PCM, and 109 MPa for ST, and in the mid-root area or perforation site were 20 MPa for PCM, 16.17 MPa for BM, 10.16 MPa for ET and 8.1 MPa for ST while the Maximum Displacement was descending assorted as 0.0179 mm for ET, 0.0169 mm for BM and PCM and 0.0151 mm for ST. In the fracture resistance test, Group A showed higher fracture resistance than other groups significantly. There was a non-significant difference between Groups B, C, and D. There was also an insignificant correlation between the maximum loading and the repairability of the tooth after fracture., Conclusion: FEA and fracture resistance test showed that the 2 repair materials are acceptable and recommended in iatrogenic mid-root perforation., Competing Interests: Declarations Ethics approval and consent to participate The Research Ethics Committee in the Faculty of Dentistry at Cairo University has approved this research. Consent for publication All images included in this study are original to this research of extracted teeth and upon which mathematical equations are applied on. No patients are involved in this study. Not applicable. Competing interests The authors declare no competing interests., (© 2024. The Author(s).)

Stainless-steel crowns (SSCs) are the most durable restorative option for deciduous teeth, although they are unsightly. However, prefabricated zirconia crowns (ZCs) look more pleasant but require substantial dental preparation. Recently, BioFlx crowns have been introduced as a white-colored alternative to SSCs, providing both flexibility and aesthetics. However, clinical trials have not assessed their oral cavity load-bearing capacity and suitability for repairing severely decayed deciduous teeth. To address this gap, the present study compared the shear stresses generated by BioFlx crowns, ZCs and the gold standard SSCs when restoring extensively decayed deciduous teeth using finite element analysis (FEA). The restoration was represented by three finite element models with the identical tooth structure: BioFlx, SSC and ZC, constructed using a Trios 3 scanner and exported for analysis using ANSYS. The FEA results showed that ZCs had the maximum axial static load stress at 40.91 MPa, followed by SSCs at 39.331 MPa and BioFlx at 14.009 MPa. ZCs produced 2.932 MPa at 45°, SSCs 3.005 MPa and BioFlx 0.3227 MPa. ZCs had a maximum primary stress of 3.055 MPa at 0°, while SSCs and BioFlx had 2.3 and 0.3017 MPa, respectively. Deformation analysis revealed that under a load direction of 90°, SSCs deformed by 5.978 mm, ZCs by 5.971 mm and BioFlx by 5.971 mm. When the load was applied at an angle of 45°, SSCs deformed by 6.527 mm, ZCs by 5.444 mm and BioFlx by 5.447 mm. SSCs deformed 5.452 mm at 0° load, while ZCs and BioFlx deformed 6.472 and 6.479 mm, respectively. Based on these findings, BioFlx crowns, in combination with the underlying core material, can withstand maximum loads, suggesting that a mutilated primary posterior tooth restored with glass ionomer cement and a BioFlx crown may be a viable option for frequent clinical use., Competing Interests: Theauthorsdeclarenoconflictofinterest. GiuseppeMinervini isservingasoneoftheEditorialBoardmembersofthisjournal. We declare that Giuseppe Minervini had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to AS., (©2024 The Author(s). Published by MRE Press.)

Background: To investigate the effects of thermal cycling and surface treatment methods on the bonding effectiveness of multi-step resin cements to CAD/CAM blocks., Methods: A total of 198 slices, 66 each from CAD/CAM blocks (feldspathic ceramic: Vitablocs TriLuxe Forte, V; resin matrix ceramics (RMCs): Cerasmart, C; and Shofu Block HC, S), were obtained and randomly divided into two subgroups for etching with hydrofluoric acid (HFA) and sandblasting with Al 2 O 3 (SB). After the surface treatments, one etched and one sandblasted sample of each CAD/CAM block was observed via SEM analysis at 500× magnification. The remaining 32 etched and 32 sandblasted samples of each CAD/CAM block were divided into two subgroups to be cemented with total-etch (TE) and self-etch (SE) resin cements. Then, half of the 16 samples in all the subgroups were subjected to aging (TC) for 5000 cycles (n = 8). The shear bond strength (SBS) of each sample was measured. Four-way analysis of variance (ANOVA) and Tukey tests were used to analyze the data (p < 0.05)., Results: With or without TC, the highest SBS values for V were obtained with the HFA-TE and HFA-SE interactions, respectively. C presented the highest SBS values with HFA-SE and SB-TE interactions, whereas S presented the highest SBS values with SB-TE and HFA-TE interactions. Except the SB-SE interaction, C presented lower SBS values after TC than other materials. HFA created less porosity on the C and S surfaces than V. SB visibly roughened the surfaces of all the materials but caused fractures, cracks, and damage to the surfaces., Conclusion: Similar SBS values can be achieved between feldspathics, RMCs, and multi-step adhesive resins with both HFA and SB treatments. However, the SBS values obtained from the SB-SE interaction may be below the recommended threshold values for all materials after TC. SB can cause distinctive cavities, fissures, and damage, especially on the surfaces of RMCs., (© 2024. The Author(s).)

Objective: This study aimed to evaluate stress distribution in unilateral maxillary defects using finite element analysis (FEA) to compare subperiosteal (SI) and zygomatic implants (ZI)., Materials and Methods: A 3D model of a unilaterally atrophied maxilla was reconstructed from CT scans. Five scenarios were simulated: (1) quad zygoma implants (SC1), (2) zygoma and conventional implants (SC2), (3) two-piece SI and conventional implants (SC3), (4) one-piece SI and conventional implants (SC4) and (5) one-piece SI implant (SC5). Mechanical properties were assigned based on data in the literature; a 450 N force for occlusal loading and a 93 N force for oblique loads were applied., Results: Under vertical loading, SC2 exhibited the highest tensile stress (Pmax) in the atrophic region (R-AM), while SC4 showed the lowest Pmax across the entire maxilla, indicating better stress distribution. Under oblique forces, SC2 also showed the highest Pmax in R-AM, while SC5 had the lowest Pmax overall. Minimum principal stress (Pmin) followed similar patterns, with SC4 and SC5 demonstrating lower stress levels than the other scenarios. Abutment stresses were highest in SC2 and lowest in SC4. Overall, the SI scenarios (SC3-SC5) exhibited lower stress transmission to the alveolar bone than the ZI scenarios (SC1 and SC2), with SC4 providing the most balanced stress distribution across all regions., Conclusions: SI implants, mainly the one-piece SI (SC4), offered a more favourable stress distribution than ZI implants in unilateral maxillary defects, reducing the risk of excessive bone stress. This finding suggests that SI implants may be superior for such cases, although individual patient anatomy should guide implant selection. Further clinical studies are necessary to confirm these biomechanical findings in vivo., Clinical Relevance: This study underscores the crucial role of implant selection in minimising stress on the alveolar bone in unilateral maxillary defects. Based on these findings, we recommend personalised implant strategies based on biomechanical insights to enhance outcomes in maxillofacial reconstruction., (© 2024. The Author(s).)

Background: Various types of crowns are used for full-coverage restoration of primary teeth affected by caries, developmental defects, or after pulp therapy. Prefabricated Stainless Steel and Zirconia crowns are commonly utilized. Bioflx crowns, which blend the properties of Stainless Steel and Zirconia, provide a flexible and aesthetically pleasing alternative., Aim: This study aimed to evaluate the vertical marginal gap and fracture resistance of Bioflx pediatric crowns compared to Zirconia and Stainless Steel crowns following thermomechanical aging., Methods: This in-vitro study was conducted using mandibular second primary crowns of three different materials (n = 30). Crowns were divided into three groups; Zirconia crowns group (n = 10, Nu Smile, USA), Bioflx crowns group (n = 10, Nu Smile, USA) and Stainless Steel crowns group (n = 10, Nu Smile, USA). The crowns were cemented onto standardized acrylic resin dies and subjected to thermomechanical aging. Vertical marginal gap measurements were obtained using a USB digital microscope with an integrated camera, while fracture resistance was assessed with a universal testing machine. Data were analyzed for outliers and tested for normality using the Shapiro-Wilk or Kolmogorov-Smirnov tests, with statistical significance set at 0.05., Results: Significant differences were observed in the vertical marginal gaps among the groups after cementation and thermomechanical aging (P = 0.013 and P = 0.001, respectively). Zirconia crowns exhibited the largest average marginal gap, followed by Bioflx and Stainless Steel crowns. Stainless steel crowns demonstrated the highest fracture resistance, followed by Bioflx crowns, while Zirconia crowns showed the lowest., Conclusions: Bioflx crowns exhibit the largest vertical marginal gap but show greater fracture resistance compared to Zirconia crowns, although they are still less resistant than Stainless Steel crowns after undergoing thermomechanical aging., (© 2024. The Author(s).)

Resin cements are widely used to cement dental restorations; however, limited studies are available on the bond strength of these cements to computer-aided design/computer-aided manufacturing (CAD/CAM) base metal alloys. This study compared the shear bond strength between a self-etching resin cement (Panavia F 2.0) and a millable cobalt-chromium alloy (Ceramill Sintron) following various surface treatments. A total of 40 cylindrical alloy cores (6 mm in diameter × 8 mm in height) were milled and assigned to 1 of 5 groups for different surface treatments (n = 8): control (no surface treatment); sandblasting; metal primer; sandblasting + metal primer; or acid etching. Resin cement was then used to bond cylindrical composite resin specimens to the pretreated core surfaces. The specimens underwent a 1500-cycle thermocycling procedure and shear bond strength testing. The data were analyzed using 1-way analysis of variance, and P < 0.05 was considered statistically significant. The mean (SD) shear bond strength values in the different surface treatment groups were significantly different (P < 0.05): sandblasting, 16.59 (7.10) MPa; acid etching, 15.63 (2.94) MPa; sandblasting + metal primer, 13.28 (1.27) MPa; metal primer, 8.90 (2.08) MPa; and control, 8.86 (3.57) MPa. The mean differences in shear bond strength values were significant between the sandblasting and control groups (P = 0.003) and between the acid-etching and metal primer groups (P = 0.013). Surface roughening procedures--either sandblasting or acid etching of the alloy surface--improved the shear bond strength of resin cement to milled alloy surfaces. The use of metal primer between the alloy surface and resin cement did not significantly increase the bond strength., Competing Interests: No conflicts of interest reported.

The purpose of this study was to compare the flexural strength, Weibull modulus (reliability), marginal gap, and internal fit (internal gap) of 4 materials for milling or 3-dimensional (3D) printing of definitive and provisional crowns: IPS e.max CAD (IEC), Paradigm MZ100 Block (PMB), Permanent Crown Resin (PCR), and Temporary CB Resin (TCR). Flexural strength was tested by subjecting sectioned milling blocks (IEC and PMB) or 3D-printed bars (PCR and TCR) to a 3-point bending test in a universal testing machine (n = 15 per material). Crowns were milled or 3D printed, and the marginal gap and internal fit were measured using microcomputed tomography (n = 5 per material). The data were analyzed with a t test and compared using analysis of variance (ANOVA) with Tukey post hoc comparisons (α = 0.05). The groups demonstrated the following mean (SD) flexural strength values: IEC, 335.50 (28.97) MPa; PMB, 154.34 (21.03) MPa; PCR, 128.09 (7.30) MPa; and TCR, 126.29 (9.23) MPa. A 1-way ANOVA revealed significant differences in the flexural strengths of sectioned and 3D-printed bars (P < 0.001). The PMB group showed the lowest Weibull modulus (8.77), indicating its poor reliability. The IEC group showed the smallest marginal gap, 53.42 (31.99) μm; this value was significantly smaller than the gap in the TCR group (P < 0.001) but not the PCR or PMB group. The PMB group had the smallest internal fit discrepancy (87.44 [37.60] μm) but was not significantly different from PCR, while TCR had a significantly greater internal fit discrepancy (130.61 [65.16] μm) than IEC, PMB, and PCR (P < 0.001). The occlusal internal fit discrepancies of 3D-printed crowns were significantly greater than those of milled crowns (P < 0.001). There was no statistically significant difference in flexural strength between the 3D-printed definitive (PCR) and provisional (TCR) materials. When the data were combined according to manufacturing method, the marginal gap and internal fit of crowns fabricated with 3D printing were comparable to those of milled crowns, and all mean marginal gaps were within a clinically acceptable limit of less than 120 μm., Competing Interests: No conflicts of interest reported.

The purpose of this study was to evaluate the influence of simplified ceramic surface treatments on the microshear bond strength (μSBS) of 2 resin cements to a zirconia-reinforced lithium silicate (ZLS) material. Blocks of ZLS were sectioned to obtain a total of 90 specimens (1.5 mm thick), which were assigned to 9 different surface treatment protocols (n = 10). Either hydrofluoric acid (HF) surface conditioner or ammonium polyfluoride self-etching ceramic primer (Monobond Etch & Prime [MEP]) was used for surface treatment and then combined with different bonding strategies (Monobond N silane-based universal primer, Prosil silane coupling agent, Ambar Universal APS self-etching adhesive, and/or Signum Zirconia Bond methyl methacrylate-based bonding system [SZB]) and luting agents (Allcem or Multilink Automix dual-curing resin cement). Composite resin cylinders were bonded to ZLS with each of the cementation protocols, and the specimens were subjected to 6000 thermal cycles from 5°C to 55°C prior to the μSBS evaluation. The failure mode was analyzed with the aid of a stereoscopic loupe. Statistical analyses were performed with 1-way analysis of variance and Tukey HSD test (α = 0.05). The HF and MEP protocols resulted in significantly higher μSBS values (P < 0.001), while conditioning with SZB resulted in the lowest μSBS. Multilink Automix groups presented higher μSBS values than Allcem groups (P < 0.01). There was no statistically significant difference in the μSBS values of the MEP + Allcem groups based on whether or not an adhesive layer was applied. The failure mode was predominantly adhesive for all specimens. The results indicate that the ammonium polyfluoride-based material MEP may be used as a substitute for surface treatment with HF and silane, but the use of a zirconia primer alone is not advised for bonding to a ZLS ceramic material., Competing Interests: No conflicts of interest reported.

Objective: This study aimed to evaluate the mechanical and physical properties of dental dam sheets used for absolute isolation and to correlate the mechanical parameters with cost., Methods and Materials: Twenty-one dental dam sheets were tested: ALLPRIME; Madeitex; Sanctuary non-latex, Sanctuary latex black, green, and blue; Nic Tone blue and black; Mk Life; Elastidam; Bassi; Pribanic; Care; OK; MDC Dental; Keystone; Dura Dam; Flexidam; Sanctuary blue; Nic Tone blue; Ehros; and USE. The thicknesses of the dental dam sheets were measured using a digital micrometer (Mitutoyo). The dental dam sheets (n=15) were prepared by cutting the samples with dimensions of 80 × 10 mm with a 1.7 mm hole made at the center of each specimen, following the ISO 9001 standard. The specimens were tested using a universal testing machine (Emic) at a speed of 500 mm/min until rupture to calculate rupture force (RF, N), elongation (%), and ultimate tensile strength (UTS, MPa), their thickness (mm) was measured using a digital micrometer, and scanning electron microscopy and X-ray energy dispersive spectroscopy were performed to analyze the structure and composition. The radiopacity was measured using digital radiography. Thickness, UTS, RF, and elongation data were analyzed by one-way ANOVA and Tukey's test (α=0.05)., Results: The Flexidam dental dam had the largest thickness (0.5 mm), while Nic Tone had a median thickness of 0.3 mm; the RF value (41.3 N) was higher for the thicker dental dams. The other dental dams had RF values ranging from 19 to 30 N. The highest elongation was obtained for the non-latex Sanctuary dental dam (600 mm). The Bassi dental dam had the highest UTS value (15 MPa), and medium and small particles were observed in most of the gums. A loss of continuity was detected in the structure of Sanctuary green and blue media. The predominant elements in the sheets were carbon, magnesium, sulfur, silicon, and calcium., Conclusions: The UTS, RF, and elongation varied substantially, indicating insufficient standardization of dental dam sheets. Nonetheless, most of the tested dental dams exhibited mechanical and physical properties suitable for clinical use. The correlation between the cost and mechanical properties of the dental dams was very low., (©Operative Dentistry, 2024.)